Healthcare Provider Details

I. General information

NPI: 1558199729
Provider Name (Legal Business Name): ARIKA PLOETZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 N 13TH ST
SHEBOYGAN WI
53081-3281
US

IV. Provider business mailing address

1125 N 13TH ST
SHEBOYGAN WI
53081-3281
US

V. Phone/Fax

Practice location:
  • Phone: 920-803-1617
  • Fax:
Mailing address:
  • Phone: 920-803-1617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number8674
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: